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Your aortic root is the portion of your aorta, or the main artery in your body, that is just above your aortic valve. Aortic root surgery is performed to treat an aortic root aneurysm, which is a weakening in the wall of your aortic root.
UPMC surgeons perform advanced aortic root surgery, including aortic valve-sparing surgery known as the David procedure.
Your aortic root is the portion of your aorta, or the main artery in your body, that is just above your aortic valve. Aortic root surgery is performed to treat an aortic root aneurysm, which is a weakening in the wall of your aortic root.
When an aneurysm is located in the aortic root, it is impossible to treat it without also addressing the aortic valve. UPMC experts offer the David procedure, a valve-sparing aortic root surgical procedure.
Doctors can provide surgical treatment for aortic root aneurysm by:
Types of aortic root surgery include:
Your surgeon will repair your aortic root aneurysm with a fabric tube called a graft. Your surgeon may use a technique called the David procedure to remove and replace the diseased part of your aorta while preserving your aortic valve.
Your surgeon may recommend repairing your aortic root aneurysm with a minimally invasive EVAR procedure. Whether or not you can have an EVAR procedure depends on the aneurysm's shape, location, and extent.
You may need aortic root surgery if your aortic root aneurysm is 50 percent larger than the rest of your artery. Doctors mainly suggest surgery when an aortic root dilation reaches five centimeters.
If you have been diagnosed with an aortic root aneurysm, you may be a candidate for surgery if you are at high risk of a life-threatening aortic rupture. Aortic aneurysm rupture is a serious, life-threatening condition with a low survival rate.
Like any medical procedure, aortic root surgery can have risks, including:
Your doctor will explain the aortic root surgical procedure to you and answer your questions. To prepare for the procedure, you should:
On the day of your procedure, be sure to bring your photo ID and health insurance card(s). Leave valuables such as cash and jewelry at home. If you have a CPAP machine, please bring it with you.
You may need to stay in the hospital for several days after your procedure. You should bring toiletries, a robe, slippers, a cell phone and charger, medications, and a change of clothes. You should also arrange for someone to drive you home from the hospital after you are discharged.
Aortic root surgery takes 4-6 hours, depending on the complexity of your procedure.
You will be positioned on a table and placed under general anesthesia. After you are asleep, you will be connected to a heart-lung bypass machine that will take over the function of your heart and lungs during your operation. Your doctor will then make an incision in your chest to access your heart and aortic root.
Depending on your condition, your doctor may be able to remove and replace the diseased section of your aorta while preserving your aortic valve. This valve-sparing technique is called the David procedure.
During the David procedure, your surgeon will remove your ascending aorta and coronary arteries just above your aortic valve, attach a synthetic graft with small stitches, and reattach your coronary arteries to the synthetic graft. As a result, the David procedure eliminates the need to replace your aortic valve with a mechanical valve.
An advantage of the valve-sparing aortic root replacement procedure is that you will not need blood-thinning medications. The synthetic graft used in the David procedure is very durable, and your own aortic valve can function normally.
Your surgeon will repair your aorta using a graft attached to a small tube called a catheter. The catheter is inserted into a small incision in your leg and guided to the damaged area of your aorta.
When your procedure is completed, you will be moved to recovery for observation and monitoring. Your doctor will provide more information about your recovery. Most people spend about a week in the hospital after open aortic root surgery, but people who have an endovascular repair may have a shorter hospital stay.
Your doctor will provide more information about your recovery after aortic root surgery and will let you know when you can resume your normal activities.
Most people completely recover in 2-3 months after open surgery. If you had an endovascular repair, your recovery may be faster. You should follow your doctor's instructions and attend all follow-up appointments.
You should call your doctor if you are experiencing any unusual symptoms, including:
If any of these symptoms are severe or if you experience loss of consciousness, you should dial 911 immediately.
Many patients can live full, active lives with routine follow-up care after aortic root surgery. However, to reduce the risk of aortic injury, you may need to avoid strenuous activity and take medication.
Aortic root surgery is highly successful at reducing the risk of aortic rupture and preventing the recurrence of an aortic root aneurysm.
Our specialists are among the most experienced in the region at performing aortic root surgery. We use the latest valve-sparing techniques whenever possible to preserve the normal function of your aortic valve and eliminate the need for lifelong blood-thinning medications.
By UPMC Editorial Staff. Last reviewed on 2024-10-01.
